Correlation of Videofluoroscopic Swallowing Study Findings With Radionuclide Salivagram in Chronic Brain-Injured Patients

Shim Ga Yang; Oh Ju Sun; Han Seunghee; Choi Kyungyeul; Lee Son Mi; Kim Min Woo

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자료유형: 학술저널

저자정보: Shim Ga Yang (Department of Physical Medicine and Rehabilitation Seoul Medical Center Seoul Korea) Oh Ju Sun (Department of Physical Medicine and Rehabilitation Seoul Medical Center Seoul Korea) Han Seunghee (Department of Physical Medicine and Rehabilitation Seoul Medical Center Seoul Korea) Choi Kyungyeul (Department of Physical Medicine and Rehabilitation Seoul Medical Center Seoul Korea) Lee Son Mi (Department of Physical Medicine and Rehabilitation Seoul Medical Center Seoul Korea) Kim Min Woo (Department of Physical Medicine and Rehabilitation Seoul Medical Center Seoul Korea)

저널정보: 대한재활의학회 Annals of Rehabilitation Medicine Annals of Rehabilitation Medicine 제45권 제2호

발행연도: 2021.1

수록면: 108 - 115 (8page)

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Objective To investigate the correlation between videofluoroscopic swallowing study (VFSS) and radionuclide salivagram findings in chronic brain-injured patients with dysphagia. Methods Medical records of chronic brain-injured patients who underwent radionuclide salivagram and VFSS were retrospectively analyzed. Patients were divided into two groups according to salivagram findings. Differences in patient characteristics and clinical factors, including Mini-Mental State Examination (MMSE), Modified Barthel Index (MBI), Functional Ambulatory Category (FAC), feeding method, tracheostomy state, and VFSS findings between the two groups were investigated. Results A total of 124 patients were included in this study. There were no significant differences in MMSE, MBI, FAC, feeding method, and presence of tracheostomy between the two groups. However, the incidence of aspiration pneumonia history was significantly higher in the positive salivagram group. The Functional Dysphagia Scale (FDS) was significantly associated with positive salivagram findings, especially in the pharyngeal phase. A multivariate logistic regression analysis showed that laryngeal elevation and epiglottic closure was statistically significant FDS parameter in predicting salivary aspiration on a salivagram (odds ratio=1.100; 95% confidence interval, 1.017? 1.190; p=0.018). The receiver operating characteristic (ROC) curve of FDS in the pharyngeal phase showed that an optimum sensitivity and specificity of 55.1% and 65.4%, respectively, when the cut-off value was 39. Conclusion In chronic brain-injured patients, inappropriate laryngeal elevation and epiglottic closure is predictive variable for salivary aspiration. Therefore, performing a radionuclide salivagram in patients with FDS of 39 or less in the pharyngeal phase for prevents aspiration pneumonia from salivary aspiration.

#Radionuclide salivagram #Videofluoroscopic swallowing study #Aspiration pneumonia #Deglutition

참고문헌 (20)

참고문헌 신청

Martino R / 2005 / Dysphagia after stroke: incidence, diagnosis, and pulmonary complications / Stroke 36:2756~2763

Boesch RP / 2006 / Advances in the diagnosis and management of chronic pulmonary aspiration in children / Eur Respir J 28:847~861

강유정 / 2013 / Evaluation of Salivary Aspiration in Brain-Injured Patients With Tracheostomy / Annals of Rehabilitation Medicine 37(1):96~102

김상범 / 2018 / Usefulness of Early Videofluoroscopic Swallowing Study in Acute Stroke Patients With Dysphagia / Annals of Rehabilitation Medicine 42(1):42~51

Aviv JE / 1997 / Laryngopharyngeal sensory test ing with modified barium swallow as predictors of aspiration pneumonia after stroke / Laryngoscope 107:1254~1260

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